Developmental dysplasia of hip (DDH): Role of assessing the geographical prevalence in Pakistan for screening to minimize the late presentation of DDH.

Abstract

Objective: To assess the prevalent regions of Pakistan for screening to minimize the late onset of DDH. Study Design: Retrospective study. Setting: Department of Orthopaedic & Spine Center, Ghurki Trust Teaching Hospital, Lahore. Period: January 2015 to December 2021. Methods: All the infants and children less than 15 years of age of both genders with the diagnosis of DDH at GTTH, Prime and Mercy Teaching Hospital, Mercy Teaching Hospital, Peshawar and Prime Teaching Hospital Peshawar from who received the surgical treatment (open and close reduction with or without acetabular osteotomy) were included in the study. The medical history of patients including age, gender, anatomical site, and geographic locations were retrospectively analyzed. All the data were entered and analyzed using Excel and SPSS software Version 22. Results: A total of 1390 were analyzed and diagnosed with DDH among these more than half of the children 1017(73.1%) were females while fewer than 373(26.8%) were males. The average age of children at the time of diagnosis was 4.5 years ranging from 6 months to 15 years. Almost half of the patients 960(69.1%) were diagnosed between the age of 1 to 5 years. More than half cases769(55.3%) had unilateral DDH than bilateral DDH 301 (21.7%). In this study, we assessed the majority of cases 20.3% cases were from Quetta, 10.5% from Peshawar, and 9.5% were from Lahore. Conclusion: DDH is a problem that ranges from minor acetabular dysplasia to irreversible hip dislocation. Depending on the health facilities, screening programs for early detection differ across the world. Due to lack of screening, late presentation of DDH is common and swaddling is another risk factor of it. Physical examination should be highly valuable in diagnosing early DDH, especially in Khyber Pakhtunkhwa and Balochistan's various cities as these are highly deprived areas where health services are inadequate and the prevalence of late diagnosis is very high. Awareness should be done among parents regarding safe methods to safely swaddle their infants.